health care service plan or other entity marketing long-term care insurance
coverage in this state, directly or through its producers, shall:
Establish marketing procedures and
producer training requirements to assure that:
(a) Any marketing activity, including
comparison of policies by its producers, will be fair and accurate;
(b) Excessive insurance is not
sold or issued.
Display prominently by type, stamp or other appropriate means, on the first
page of the outline of coverage and policy the following notice:
"Notice to buyer: This policy may not cover all of the costs
associated with long-term care incurred by the buyer during the period of
coverage. The buyer is advised to review carefully all policy
to the applicant copies of the disclosure forms required in Section
(4) Inquire and otherwise make every
reasonable effort to identify whether a prospective applicant or enrollee for
long-term care insurance already has accident and sickness or long-term care
insurance and the types and amounts of any such insurance, except that in the
case of qualified long-term care insurance contracts, an inquiry into whether a
prospective applicant or enrollee for long-term care insurance has accident and
sickness insurance is not required.
(5) Establish procedures, readily subject to
audit by the superintendent, for verifying compliance with this
(6) Provide written notice
to prospective insureds at the time of solicitation of the availability of any
public or private insurance counseling program for senior citizens, such notice
to include the name, address and telephone number of each program.
Assure that any policy, certificate or
rider conforms to the definitional requirements in Section
"noncancelable," "level premium" and any other word of similar
Explain the contingent
nonforfeiture benefit upon lapse described in Section
applicable for policies issued or renewed on or after January 1, 2008, the
additional contingent benefit upon lapse provided to policies with fixed or
limited premium paying periods in Section
In addition to the practices
the following acts and practices are prohibited:
High pressure tactics.
Employing any method of marketing having the effect of or tending to induce the
purchase of insurance through force, fright, threat, whether explicit or
implied, or undue pressure to purchase or recommend the purchase of
advertising. Making use directly or indirectly of any method of
marketing which fails to disclose in a conspicuous manner that a purpose of the
method of marketing is solicitation of insurance and that contact will be made
by an insurance agent or insurance company.
The following requirements apply to
association groups as defined in
(1) With respect to the obligations set forth
in this subsection, the primary responsibility of an association when endorsing
or selling long-term care insurance shall be to educate its members concerning
long-term care issues in general so that its members can make informed
decisions. Associations shall provide objective information regarding long term
care insurance policies or certificates endorsed or sold by such associations
to ensure that members of such associations receive a balanced and complete
explanation of the features in the policies or certificates that are being
endorsed or sold.
shall file with the insurance department the following material:
(a) The policy and certificate,
(b) A corresponding outline of coverage,
(c) All advertisements
requested by the insurance department.
The association shall disclose in any
long-term care insurance solicitation:
The specific nature and amount of the compensation arrangements (including all
fees, commissions, administrative fees and other forms of financial support)
that the association receives from endorsement or sale of the policy or
certificate to its members; and
A brief description of the process under which the policies and the insurer
issuing the policies were selected.
(4) If the association and the insurer have
interlocking directorates or trustee arrangements, the association shall
disclose that fact to its members.
(5) The board of directors of associations
selling or endorsing long-term care insurance policies or certificates shall
review and approve the insurance policies as well as the compensation
arrangements made with the insurer.
The association shall also:
(a) At the time of the association's decision
to endorse, engage the services of a person with expertise in long-term care
insurance not affiliated with the insurer to conduct an examination of the
policies, including its benefits, features, and rates and update the
examination thereafter in the event of material change;
(b) Actively monitor the marketing efforts of
the insurer and its agents; and
Review and approve all marketing materials or other insurance communications
used to promote sales or sent to members regarding the policies or
(d) Subparagraphs (a)
through (c) shall not apply to qualified long-term care insurance
(7) No group
long-term care insurance policy or certificate may be issued to an association
unless the insurer files with the state insurance department the information
required in this subsection.
The insurer shall not issue a long term care policy or certificate to an
association or continue to market such a policy or certificate unless the
insurer certifies annually that the association has complied with the
requirements set forth in this subsection.
(9) Failure to comply with the filing and
certification requirements of this section constitutes an unfair trade practice
in violation of 24-A M.R.S.A. Chapter 23.